Verrucous Melanoma of the Scalp Initially Misdiagnosed as Seborrheic Keratosis

Verrucous melanoma (VM) is a rare entity that presents diagnostic difficulty on both clinical and histopathologic grounds. Clinically, this tumor can be mistaken for a benign non-melanocytic lesion, particularly seborrheic keratosis (SK), as they both share several similarities, such as the homogenous pigmentation, the verrucous surface, and the roughly well-defined borders. In our patient’s case, her verrucous lesion was initially misdiagnosed as SK by a general practitioner two months prior to her admission. Upon physical examination, the lesion was indeed suggestive of SK but a VM was not discarded. Biopsy revealed melanoma. Standard treatment of SK often includes electrodesiccation or cryotherapy, which potentially might worsen and delay the diagnosis of melanoma with subsequent implications for therapeutic management and prognosis. We report this case to increase awareness and knowledge about VM, which may lead to earlier diagnosis and improved outcomes.